1. Field of the Invention
The field of the invention is devices adapted to enlarge holes in the ostomy adhesive wafers for use by colostomy, ileostomy, and urostomy patients.
2. Description of the Related Art
In patients who have had extensive medical problems with their colon, ileum, bladder, or kidneys, it is sometimes necessary that the colon, ileum, or tubes from the bladder or kidneys be routed from their normal attachments to an opening on the body in the lower abdomen region, many times in about the area immediately below where a person wears their belt. A stoma is an opening made in the skin covering the abdomen to which the lower end of the colon, ileum, or other tube has been attached. Many times the patient is given no means by which to control the flow of wastes through the upper or lower bowels or bladder and out the opening or stoma made in the stomach or abdomen wall. As a consequence, measures must be made to receive and hold these waste products. To accomplish this, various medical supply companies distribute apparatus for the collection of urine and feces. This apparatus generally consists of an ostomy bag which is supported upon the body of the patient, the bag having an upper opening which encompasses the stoma opening.
The problem with the ostomy apparatus is that an air and water tight seal must be made between the upper opening of the ostomy bag and the stoma in the wall of the abdomen in order to maintain sanitary conditions. To this end, the medical supply companies provide an adhesive wafer which adheres to a person's skin, the wafer being flat and annular in shape and adapted to encompass the periphery of the opening in the abdomen wall. On one side of the wafer is a non-skin irritating adhesive for holding the wafer to the person's skin and on the other flat side of the wafer is attached an annular plastic ring, the ring so configured to be encompassed by a second ring which forms the opening of the ostomy bag in a waterproof seal.
Most ostomy wafers are provided with a nominal 1/2 inch diameter central pilot opening which, in the majority of the patients cases, must be enlarged to accommodate the size of the particular patient's stoma since it is not desirable or sanitary to block or partially block the flow of the wastes from the patient's body into the ostomy bag.
Accordingly, the ostomy bag kits provided by the medical supply companies provide instructions to the patient to enlarge the opening through the ostomy wafer utilizing a pair of scissors, all of this accomplished before the ostomy wafer is placed on the skin of the person. To aid in enlarging the opening through the wafer, and to protect against contamination, a detachable plastic or paper cover is adhered to the adhesive on the wafer. This cover is then removed prior to the attachment of the wafer to the patient.
Various devices have been devised to enlarge this ostomy wafer opening and have been disclosed in various patents as follows. These devices take the form of a punch utilizing a circular cutting edge which is forced through the ostomy wafer. The first, being a pliers type punch, is seen in the 1989 patent to Arnold, U.S. Pat. No. 4,817,287 where, in the jaws attached to the handle of the pliers open and close, one of the jaws has the attached annular cutting blade and the other has a disk with an annularly shaped cutting groove therein. The ostomy wafer is placed between the jaws of the pliers with the central opening of the wafer generally centrally located in the disc having the cutting groove. The handles of the pliers are brought together to force the jaws together to cut the opening through the wafer.
The other type of punch type ostomy wafer known to the inventor is shown in a 1983 patent to Sunderland, U.S. Pat. No. 4,391,042, wherein a non-circular opening is made by using a similarly shaped cutting element. The device is positioned over the already existing hole in the adhesive wafer and with a handle attached to the cutting element, the cutting edge is forced through the wafer. The wafer rests upon a support block of wood during the punching operation, the wood having a cover of vinyl plastic.
While the above devices obviously do accomplish their purpose of enlarging the opening through the ostomy wafer, yet they do require some amount of force on the part of the patient or other operator to push the cutting edge through the ostomy wafer. Inasmuch as many ostomy patients may be elderly, the required application of force to a pliers type instrument or to a punch type instrument may be more than the patient is capable of.
In addition, it is obvious from using the punch type ostomy wafer hole cutters of the above two patents, means are needed to reasonably assure that the newly cut opening through the wafer is generally centrally located. If the opening to be enlarged was not directed to be centrally located, opportunity for the patient to place the opening too close to the outer peripheral edge of the wafer is provided. In such event, opportunity for leakage of the contents of the bowel to pass by the adhesive may be possible if there is insufficient width of the adhesive around the ostomy wafer opening for a full sealing.
Accordingly, it is readily apparent that there is need for apparatus which will enlarge the already existing opening through the ostomy wafer with a new opening which is concentric with the previously formed opening in order to ensure that as much adhesive as possible is present on all parts of the adhesive wafer surrounding the opening.
It is also obvious that there is need for an ostomy wafer hole cutter which may be operated by a person without the application of force needed to punch a hole through the ostomy wafer.